Baseline Characteristics, Vision-related Quality of Life, and Their Associations in the Complications of Age-related Macular Degeneration Prevention Trial (CAPT)

Abstract

Abstract: : Purpose: To describe baseline characteristics and vision-related quality of life (VRQOL) among CAPT participants and to investigate their associations. Methods: 1052 CAPT participants with ≥ 10 large drusen and visual acuity ≥ 20/40 in each eye participated in this multi–center randomized clinical trial. At baseline, each participant completed the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), an additional 10-item night-vision related questionnaire (NVRQ-10), visual acuity testing (ETDRS Charts 1, 2), contrast sensitivity testing (Pelli-Robson chart), reading speed (MN Read Charts), stereo color photography and fluorescein angiography. Masked, professional graders evaluated fundus images. Associations of the NEI-VFQ-25 and NVRQ-10 with the measures of vision and the fundus features were assessed with the Spearman correlation coefficient and multiple linear regression. Results: Of the1052 participants with mean age 71 yrs (range 50-90 yrs), 61% were female, 99% were white, 65% had VA ≥ 20/20 in better eye, and 34% have VA ≥ 20/20 in worse eye. 47% of better eyes and 23% of worse eyes require ≤2% contrast to read large letters. 92% of better eyes and 64% of worse eyes have critical print size ≤20/50 Snellen Equiv. The mean (SD) of overall score of NEI-VFQ-25 and NVRQ-10 at baseline were 8810 and 7020 respectively, their correlation with the visual acuity, contrast sensitivity and reading speed from the better eye ranged from 0.21 to 0.29 (p<0.01). Of all the subscales of the NEI-VFQ-25, the general vision, near vision and distance vision had the strongest association with visual acuity, contrast sensitivity and reading speed (r=0.19-0.37, p<0.01). The participants with better visual acuity, contrast sensitivity and reading speed significantly had higher overall score of NEI-VFQ-25 and NVRQ-10 with the adjustment of possible confounders from multiple linear regression analyses. The fundus features were not significantly associated with either NEI-VFQ-25 or NVRQ-10. Conclusions: CAPT participants at baseline had good visual function on traditional measurement, but decreased scores on the NEI-VFQ-25 and NVRQ-10. Although measures of visual function were significantly associated with vision-related quality of life, the correlation was modest. The perception of VRQOL among CAPT patients could not be predicted by their fundus features.

Keywords: 308 age-related macular degeneration • 536 quality of life